A Spike of Ignorance, Not COVID in Colorado

Closing schools to in-person learning again? Really? Government officials are decrying a spike in cases and hospitalizations, and media outlets are breathlessly sharing out-of-context graphs indicating rapidly spreading calamity. Fortunately, they are lying. Whether out of ignorance (because they are still stuck on the original narrative that COVID is an equal opportunity mass killer) or malice (trying to cover up their role in 2020’s widespread economic destruction), Colorado government officials and media haven’t learned a thing about infectious disease or how using flawed epidemiological definitions can lead to disastrous policy positions and horrible government overreach.

As with many disastrous fallacies, this latest return to stupid is a problem of definitions:

Prior to COVID-19, epidemiologists understood and reported respiratory viral disease (such as influenza) in terms of infections and cases. An infection was a person who had the specific live virus present in their system, while a case was a person who developed significant symptoms due to the strength of infection in their system, requiring medical intervention.

In the case of influenza, a case was generally a person who was admitted to hospital because of the flu, and we estimated additional seasonal cases based on the understanding that many people (especially younger ones) don’t go to the doctor or the hospital even when they get sick from the infection. Similarly, we had to estimate seasonal infections because many people infected experienced mild or no symptoms. An influenza death was a person who died with influenza being the cause or a significant contributing factor to death, although this number remains highly subjective because autopsies are rarely performed on older patients (who suffer the most from the flu), and death certificates in non-controversial circumstances are highly subjective and largely inconsequential.

Flu data was (and still is) reported in terms of estimated infections, partially estimated cases, and partially estimated deaths. The idea of a flu “hospitalization” is contained in the case number, since a flu infection is not considered a “case” until the patient goes to the doctor or hospital.

With COVID-19, government officials, health experts, and the media have made no effort to use the same definitions used for every other respiratory virus in history. We accept that there is a big difference between a coronavirus infection (anywhere between asymptomatic and seriously ill) and a case (sick enough to display significant symptoms), yet this distinction was wiped out.

Furthermore, the public does not even discuss the syndrome known as COVID-19, where a person develops serious enough symptoms to cause the bacterial pneumonia that is the actual cause of death from the viral infection. The WHO requires the presence of this pneumonia for a death to be considered a “COVID-19 death,” but the United States (unlike countries like Singapore) has largely ignored this requirement. We refer to people who are not even sick as having COVID-19, even though they have never and will never develop the deadly syndrome.

Instead, we report every infection, no matter how symptomatically insignificant, as a “case.” We report every person admitted to the hospital with a positive PCR test as a “hospitalization,” regardless of whether they were admitted to the hospital for COVID-19 symptoms or not, failing to report that hospitals largely test everyone admitted. Unfortunately, HIPAA protections prevent us (and similarly prevent the government) from knowing how many “hospitalizations” are because of COVID-19 versus simply an incidental positive test. Beyond that, the public is being encouraged to get tested for any and every reason, whether we are symptomatic or not, resulting in tens of thousands of tests being performed every day in Colorado – largely on people with no symptoms. We know many have no symptoms of COVID-19 because 9 out of 10 test negative. And Colorado does not require an actual positive test for a person to be considered a case or a hospitalization – they can be presumed positive based on subjective circumstances like proximity to someone who has tested positive.

Because the virus is highly infectious, this widespread testing inevitably reveals widespread (mostly low risk) infection, but which the media and experts report under the umbrella of cases and hospitalizations – absent any context of real risk. This is precisely what would happen every single year if we encouraged and ramped up widespread influenza testing. We would uncover widespread flu infection, report flu “cases” and “hospitalizations,” making it appear as if the flu was spreading out of control. We would lockdown, wear masks, and do remote learning every single year! The brand new definitions used to describe the pandemic (seen above) and the initiation of widespread testing is creating the appearance of an out-of-control pandemic, when this virus actually presents very little real danger to anyone outside very specific vulnerable demographics. In fact, the only reliable predictor of a person’s risk from this coronavirus is the strength of their own immune system. Our so-called experts have created a very hazy view of what is going on, and what they are telling us favors the most catastrophic understanding possible.

We also know that financially-strapped hospitals are given more money for COVID-19 patients, which creates an incentive to use a standard for “case” that is as wide as possible. There have been reports of hospital administrators, doctors, and nurses objecting to this wide definition only to be required to use it anyway. Again, we are not allowed to know what the severity of the situation is for any of these patients – a person admitted for a hernia repair who with no symptoms of COVID-19 who happens to test positive upon admittance is considered the same as someone on their deathbed with COVID-19 pneumonia. We have admittedly anecdotal evidence for severity with the CDC reporting that 94% of COVID-19 deaths had other serious deadly conditions present, and while this doesn’t mean that only 6% of deaths were because of COVID, it does suggest a corollary pattern indicating that people without serious comorbidities have much less to fear from the virus. We also see a strong pattern of risk due to age, smoking, and general health indicators like diabetes.

Since they won’t tell us (and I suspect can’t tell us) the true medical condition of these “cases” and “hospitalizations,” the only data we have to assess the severity of COVID-19 currently is the official government reporting, with its novel and imprecise definitions. Even with this imprecision, we can determine a few things pertinent to the relative danger in Colorado public schools. First, we must understand that cases and hospitalizations as a factor of tests performed have remained very steady since late June – between 8% and 10%. Roughly 1 out of 10 people tested are positive (this also shows that the overwhelming majority of tests are being done on asymptomatic people), and roughly 1 out of 10 positive cases are hospitalizations. These calculations can be done easily with official Colorado data. We see a recent movement upward in positivity rate (positives vs tests), but this is to be expected as the virus continues to finish its spread into the population. But is this really as worrisome for schools as the media and officials say it is? Let’s take a look at what we know so far:

Students

As of November 12^th, 147,599 cases have been reported in Colorado. Approximately 15% or 22,139 of these are below the age of 20, despite this group being about 25% of the population. This likely is due to a lower testing rate among this group since they are much less likely to show the symptoms that would prompt a test. As of the same date, Five (5) COVID-related deaths are among this age group – 0.002%. If this percentage holds as the virus spreads to the rest of the population (everyone is eventually infected and counted as a case), we should expect less than 200 COVID-related deaths among people 20 or younger assuming no vaccine or advancements in therapies in a population of 1,420,000 people. This does not factor in comorbidities or other factors that increase mortality (such as cancer). This is roughly the same number in this age group that died from accidents in 2019 and represents a 1 in 7,200 chance of dying with COVID-19, or a 0.014% chance of dying once everyone gets infected. If we factor in the (admittedly imprecise) knowledge that the overwhelming majority of COVID deaths (94%) have two or more comorbidities present, we can estimate that for a healthy person under 20 in Colorado to die of COVID-19 is 0.0000833%, or statistically impossible.

Teachers

For teachers, this analysis becomes more complicated since teachers are not in such a neat age bracket, but for the sake of simplicity I’ll do the same math on 20 to 70-year-olds, knowing that when health factors remain similar the risk increases with age, but knowing that I am eliminating those who are too old to be teaching (80+) and who represent well over half of COVID deaths.

 As of November 12^th, 147,599 cases have been reported in Colorado. Approximately 77% or 114,049 of these are between the ages of 20 and 69, despite this group being about 66% of the population. As of the same date, 521 COVID-related deaths are among this age group – 23% of deaths. If this percentage holds as the virus spreads to the rest of the population (everyone is eventually infected and counted as a case), we should expect around 65,000 COVID-related deaths among people 20-69 assuming no vaccine or advancements in therapies in a population of 4,540,000. This does not factor in comorbidities or other factors that increase mortality (such as cancer). This represents a 1 in 70 chance of dying with COVID-19, or a 1.4% chance of dying once everyone gets infected. If we factor in the (admittedly imprecise) knowledge that the overwhelming majority of COVID deaths (94%) have two or more comorbidities present, we can estimate that for a healthy person between 20 and 69 in Colorado to die of COVID-19 is 0.084%.

Clearly, the risk is higher for older (healthy 60-69 has a 0.28% chance of dying) and much lower for younger (healthy 30-39 has a .009% chance of dying or about half their risk of dying in an accident).

Admittedly, the benefit of testing is that we can catch the virus early in susceptible demographics, but we shouldn’t look at raw increases in cases or hospitalizations as evidence of a growing problem, only as evidence of growing discovery. Combine the relatively low fatality risk with massive improvements in therapies (and a vaccine on the horizon), and our recipe should be to watch and care for the vulnerable but let everyone else get back to work. Students are having their academic experiences stunted in ways they may never recover from. The price we are making our students and schools pay right now is in no way scientifically justifiable and is certainly doing more harm than good. Society-wide, our response has led to the loss of millions of years of life. It is the opposite of what is needed.